A twenty-two-year-old male was admitted to the hospital in May 1970 with a high fever and headache. Blood and bone marrow examination disclosed acute lymphocytic leukemia. The patient was treated with BIKE program, which induced a complete remission of only two weeks. Thereafter remissions were obtained. two more times with L-asparaginase, daunomycin and cytosine arabinoside, Shortly before the third relapse the patient developed meningeal leukemia which caused coma of short duration. The meningeal leukemia was treated with intrathecal administration of MTX, and a complete remission was attained to after about a hundred days. But the episode left a significant change in character. Autopsy revealed dural, arachnoidal and intracerebral perivascular infiltration of leukemic cells.
